TheRubins.com

Changes to the Medicare and Medicaid Regulations as Promulgated by the CMS


Based on the email we have received and the statistical breakdown of the articles read by viewers of our Web site, we are starting a new column to get information to our readers re the latest regulatory changes to the Medicare and Medicaid regulations. We will be constantly adding to this column the new regulations promulgated by the Center for Medicare and Medicaid Services (CMS). The column will also contain sources where you can get further information about the regulation cited. Some of this information will also be integrated into the articles we have written. Our hope is that this will keep you better informed on issue related to Medicare. This column will appear every 4th day.
The Editors

March 11, 2004: Number 1: Effective January 1, 2004, enrollees of Medicare+Choice (M+C) plans have the right to an expedited review by a quality improvement organization when enrollee disagrees with their M+C plans decision to terminate Medicare services from a skilled nursing facility, home health agency or comprehensive outpatient rehabilitation facility (See: Federal Register, April 4, 2003).

March 15, 2004: Number 2: Nursing homes are not permitted to require Medicare beneficiaries pay in advance to be admitted for Medicare-covered services. Nursing homes may not deny covered in-patient services if a patient is unable or fails to pay a requested amount at or, before admission, nor may they charge patients for the assurance of a future admission. The nursing home may, however, require a deposit fee or a promissory note for services not covered by Medicare or Medicaid. (See: www.cms.gov/medicaid/survey-cert/sco417.pdf )

March 23, 2004: Number 4: According to a CMS transmittal, a Medicare beneficiary undergoing outpatient physical therapy, speech-language pathology services and outpatient occupational therapy must see a physician or nonphysician practitioner within 60 days after the therapy begins and every 30 days, thereafter. The 60 day period begins with the therapist's initial encounter with the patient. The initial encounter should occur in a timely manner after the physician's referral. In addition, the timing of recertification and visit requirements should coincide. (See: www.cms.hhs.gov/manuals/pm_trans/r5bp.pdf)

March 27, 2004: Number 5: During the 2003 legislative session, 17 states introduced legislation related to patient safety, quality improvement of healthcare delivery or both. These states were Arizona, Florida, Hawaii, Iowa, Kentucky, Massachusetts, Michigan, Missouri, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Texas, Washington, and West Virginia.



FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "HOW TO SELECT A NURSING HOME"

Harold Rubin, MS, ABD, CRC, Guest Lecturer
March 16, 2004
http://www.therubins.com

To e-mail: rehabstrat1@aol.com or rubin@brainlink.com

Return to Home

TheRubins.com